1 Most people print off a copy of the post test and circle the answers as they read through the materials. Then, you can log in, go to "My Account" and under "Courses I Need to Take" click on the blue "Enter Answers" button. After completing the post test, you can print your certificate. Chapter 1 Topics in Human Sexuality: Sexuality Across the Lifespan Childhood and Adolescence Introduction Take a moment to think about your first sexual experience. Maybe it was an experience of early masturbation, “playing doctor” or “show me yours and I’ll show you mine.” Many of us do not think of childhood as a time of emerging sexuality, although we likely think of adolescence in just that way. But the assumption that sexuality begins in adolescence is incorrect. Human sexual development is a process that occurs throughout the lifespan. There are important biological and psychological aspects of sexuality that differ in children and adolescents, and later in adults and the elderly. In an early but seminal work on child sexuality Moglia & Knowles (1997) make a powerful statement. They state: from the moment they are born, infants are learning about their bodies, learning how to love and who to trust. Parents are their primary educators about sexuality, and mental health professionals often are called upon to guide these conversations. Like others who write about sexuality in childhood, these authors recognize that sexuality begins early and that parents play a pivotal role in educating children about their sexuality and about sexual expression. As clinicians working with families, it is important to be able to respond to questions regarding what is “normative” and to establish the foundation of healthy sexuality. This chapter will review the development of sexuality using a lifespan perspective. It will focus on sexuality in infancy, childhood and adolescence. It will discuss biological and psychological milestones as well as theories of attachment and psychosexual development. Educational Objectives 1. Define sexuality and the elements that make up sexuality 2. Discuss sexuality in children from birth to age two 3. Describe Freud’s theory of psychosexual development 4. Describe the development of attachment bonds and its relationship to sexuality 5. Describe early childhood experiences of sexual behavior and how the child’s natural sense of curiosity leads to sexual development 6. Discuss common types of sexual play in early childhood, including what is normative CCM4Less.com 2 7. Discuss why it is now thought that the idea of a latency period of sexual development is inaccurate 8. Discuss differences in masturbation during adolescence for males and females 9. Discuss the stages of gay identity development 10. Discuss issues related to the first sexual experience 11. Discuss teen pregnancy What is Sexuality? Prior to looking at sexuality in children, it is important to look at an overall definition of sexuality. In the broadest sense, sexuality is defined as people's interest in and attraction to others, their capacity to have erotic experiences and responses. While children are not attracted to others in an erotic way, even at a very young age they are capable of biological and sensual (pertaining to the senses and pleasure) responses. These sensual experiences form the basis of early sexuality. Moglia and Newman (2008), discuss a number of interrelated factors that are a part of sexuality: • sexual anatomy, physiology, growth and development • sexual orientation and attraction • sexual behaviors & lifestyles, beliefs, attitudes & values • body image and self-esteem (body image can have a profound effect on healthy relationships) • sexual health • sexual fantasies and dreams • intimate relationships • life experiences as they relate to sexuality • spirituality as it relates to sexuality • gender, gender identity and gender role identity (the idea of how we should behave because we are a female or male). Sexuality is an integral part of who we are, what we believe, what we feel, and how we respond to others. These components are broad, and apply to individuals throughout the lifespan. They also interact with one another in complex ways. Freud’s Contributions to Our Understanding of Sexual Development CCM4Less.com 3 Prior to 1890, it was widely thought that sexuality began at puberty. This changed with the theories of Sigmund Freud. While in many ways Freud was a product of his times, many aspects of his theories are applicable to our current study of sexuality. Freud’s theory, aptly known as the psychosexual theory of development, involves the idea that personality development is centered on the effects of the sexual pleasure drive on an individual’s psyche, thus sex is a major motivational factor in life. The term libido refers to a person's drive or desire for sex. Freud looked at the physiological/physical aspects of libido, as well as the psychological and social aspects, and the often complex interactions between the two. Even in very young children who are experiencing physical sensations there is also an emotional component. For example, the mother’s cuddling of her child and the skin to skin contact in breastfeeding are among many peoples’ earliest sensual experiences. Freud’s theory is a stage theory, and he further identifies that at each stage of development a particular body part is most sensitive to erotic stimulation. These erogenous zones are the mouth, the anus, and the genital region. In the example above, Freud identifies the mouth as the primary erogenous zone. In 1905 Freud published Three Essays on the Theory of Sexuality, which looked at sexuality and links between early childhood experiences and adult behavior and personality. The book was a series of essays. In the essay entitled, “Infantile Sexuality,” Freud theorized that sexual feelings were present in the child from the moment of birth. He states: One feature of the popular view of the sexual instinct is that it is absent in childhood and only awakens in the period of life described as puberty. This, however, is not merely a simple error but one that has had grave consequences, for it is mainly to this idea that we owe our present ignorance of the fundamental conditions of sexual life … So far as I know, not a single author has clearly recognized the regular existence of a sexual instinct in childhood; and in writings that have become so numerous on the development of children, the chapter on “Sexual Development” is as a rule omitted. Freud writes that even in infancy, sensuality and sensual experience is a primary driving force. Parental and societal prohibitions against early sexuality result in conflicts for the child and form the basis of adult personality. According to Freud, the child must resolve a conflict during each psychosexual stage in order to advance to the next stage. If that conflict is not resolved, the child will fixate in this stage, and this will affect the child’s adult personality. While the field of mental health no longer subscribes to these theories in total, themes such as the importance of sensual gratification and parental acceptance of sexuality continue to resonate. Sexuality In Childhood (Birth To Age 2) Emotional Response CCM4Less.com 4 The first intimate relationship that children experience is with the mother or the primary caretaker. This relationship involves many of the tactile senses and includes being rocked and cuddled, being bathed, cleaned and diapered. These experiences may establish preferences for certain kinds of stimulation that persist throughout life. Physical Response Children experience pleasure in their bodies from birth onwards. People are born with the physical ability to experience sexual response. Male infants, for example, get erections, and in fact, boy babies are sometimes born with erections. Vaginal lubrication has been found in female infants in the 24 hours after birth (Masters, Johnson, & Kolodny, 1982). Infants and young children have many other sensual experiences, including sucking on their fingers and toes, and exploring their bodies, including their genitals. Fetal masturbation has been described in males in utero (Rodrı́guez, López & Cajal, 2016). Studies of very young female children have shown that young girls masturbate as early as three to fifteen months (Rödöö & Hellberg, 2013). Masturbation Masturbation is defined as “erotic stimulation especially of one's own genitals.” Masturbation is a common human behavior, said to occur in 90–94% of males and 50–60% of females at some time in their lives (Nechay, Ross, Stephenson & O'Regan, 2004). There is a vast difference in the views that societies and cultures hold of masturbation. The term masturbation is derived from the Latin words manus, meaning “hand” and stupratio, meaning “defilement”. This suggests that the practice of masturbation was thought to be unclean. In the professional literature, discussions of “infantile masturbation” portray the behavior in ways ranging from an ordinary behavior to a disorder (for example, Nechay, Ross & Stephenson et al., 2004, discuss what they term “gratification disorder.”). Infants have been observed fondling their genitals, and the rhythmic type of manipulation associated with adult masturbation appears early. The study cited in the previous section (Rödöö & Hellberg, 2013) lists such observations as early as 3 months after birth while others (e.g., Martinson, 1994) place the onset of gratification-oriented masturbation at age 2 1/2 to 3. While we cannot truly know the infant/young child’s goal with self- stimulation, it is thought to be pleasurable. In fact, there are cultures in which parents fondle infant’s genitals in order to keep them quiet (Hyde & DeLamater 2003) and soothe them in some ways (see, for example, Ahn & Gilbert, 1992). Orgasms from masturbation are possible even at a young age although boys cannot actually ejaculate until puberty. Masturbation, even at this age, is both normative and may even be optimal.